Estradiol sensitive SUPER low - what should I do?

[lancerevo]

So i've been getting my test levels checked pretty frequently since I found out I had low T back in April of this year. Little background - 26 y/o male, 175 pounds ~13% BF, lift regularly, diet super clean and watch all my macros, not currently on TRT. Been feeling the usual symptoms of low T, low libido, constant fatigue. Got my levels checked back in April and have been consistently low:

Free test: 5.5-8.1 everytime I've checked Reference range (9-26)
Total test 410-515 (324-1026)
LH: 3.3
FSH: 3.9

All other labs have been normal, and I've checked EVERYTHING. I can provide if you would like.

Now my estradiol levels were fine also I thought - I've only been checking the normal assay. They've ranged from 14-18. But after reading more on the forums I decided to get the Sensitive Estradiol test and it came back at 4 (3-70). My test is also low, is this why my Estradiol is low? Is the low estradiol causing all my symptoms, or is it the low T? How do I fix this? Start clomid, hCG, or go straight to test?

I'm also taking multi vitamin, Vit D, and DHEA

 

[lucius11]

I'm no expert on this. It does seem reasonable to assume that if your test is low, estrogen would also be low. Low estrogen does indeed suck. Going on TRT would indeed raise both. But you are 26 and I doubt anyone is going to just put you on TRT without first checking into the cause of the problem.

Did you have a history of steroid use or any other medical conditions - (Hemochromatosis, diabetes ...).

Again, I'm just a lay person but it looks to me like your FSH and LSH may be in the normal range (you did not post the reference ranges). And your total test, while not super high, is not below 300. Even if we were to say your test is "low", it looks like you would fall into the "secondary hypogonadism" camp. This usually means that the defect lies outside of the testes.

I'm older and I'm primary (FSH and LSH were high but the testes can't produce anymore testosterone). Given your age your doc will have to determine why your levels are this way. There are a bunch of things they check when you are secondary. Since you have low free test, I would think they would at least check your sex hormone-binding globulin (SHBG) level. This protein binds to test, and if this level is high it can lower your free test (as best I can recall). SHBG level being way off would explain the low free test. Not an expert on SHGB but I think thyroid could be partly involved with this protein level.

It seems to me you are on the right track - several blood levels are not ideal. I don't think you have enough info to determine what to do just yet.